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Introducao: Disseccao aneurismatica da arteria carotida interna em seu segmento cavernoso e uma lesao incomum, assim como sua associacao com hemorragia subaracnoidea. Esta descricao e relatada com traumatismo direto ou indireto da regiao cervical. Apresentamos paciente masculino de 26 anos submetido a cirurgia ortognatica que evoluiu em pos operatorio imediato, com paralisia de nervos oculares direitos (IIIo°, IVo° e Vo°) oftalmoplegia, sem quemose ou proptose e com hemorragia subaracnoidea. A angiografia revelou aneurisma dissecante da arteria carotida interna direita em seu segmento cavernoso. Na evolucao, apresentou ressangramento e a opcao de tratamento foi a embolizacao arterial com micromolas de platina. Extensa revisao da literatura foi realizada, sendo proposto tratamento endovascular como opcao terapeutica. Introduction: Aneurysmal dissection of the internal carotidartery in the cavernous segment is an uncommon lesion,as well as the association with subarachnoid hemorrhage.Its description is related to direct or indirect trauma of theneck region. We report on a 26 year-old male patient whopresented in the imediate postoperative after an orthognathicsurgery with paralysis the right ocular cranial nerves (IIIo°, IVo ° and VIo°) with ophthalmoplegia, without chemosisor proptosis and with subarachnoid hemorrhage in thecranial tomography. Angiography disclosed a dissectinganeurysm of the right internal carotid artery in the cavernoussegment, presenting with rebleeding during his evolution. Thetherapeutic option was arterial embolization with platinummicrocoils. After extensive literature review, endovasculartreatment was suggested.

Cavernous carotid traumatic dissecting aneurysm and subarachnoid hemorrhage after orthognathic surgery treated with arterial embolization